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Category: Preparing for Surgery

Categories
For Med Pros Nutrition Preparing for Surgery

Is CF(Preop)® Safe For Patients with Diabetes?

One of the most asked questions when it comes to CF(Preop)® is whether or not patients with diabetes may consume it before surgery. Today, we break down the research surrounding preoperative carbohydrate loading for patients with diabetes. We also discuss CF Nutrition’s protocol for carbohydrate loading in patients with diabetes.

 Why is preoperative carb loading necessary?

Before ERAS® protocols were discovered, the traditional approach to surgery was to fast after midnight prior to surgery to decrease the risk for aspiration. In the 1990’s, evidence-based research suggested that this was not necessary. There are detrimental effects caused by this period of prolonged fasting. Prolonged fasting worsens the catabolic state, increases metabolic stress, hyperglycemia and insulin resistance. Furthermore, when the body is fasted for a prolonged time, glycogen stores are depleted which can lead to protein and muscle breakdown. Postoperative insulin resistance (PIR), a result of the stress response from surgery and further exaggerated with prolonged fasting, is directly related to delayed wound healing, increased morbidity/mortality and LOS . To enhance recovery after surgery, it is important to decrease PIR. Preoperative carbohydrate loading maximizes glycogen stores in the body as an energy source in order to minimize degeneration of body tissues and reduce insulin resistance. By changing the metabolic state, and shortening preoperative fasting (aka providing a complex carbohydrate 2-3 hours prior to surgery), PIR will be decreased, protein loss will be reduced, and muscle function will improve.

What has CF Nutrition done to research the use of CF(Preop)® for patients with diabetes?

The founder of CF Nutrition, Dr. Lou Marsh, researched CF(Preop)® and blood glucose levels extensively. She found that after ingestion of 50 grams of carbohydrate, the blood glucose levels will spike in any individual. What becomes important is the time the patient drinks CF(Preop)® and the time the blood glucose levels are checked. This will help to see where each specific patient’s blood glucose levels are at two hours after consuming CF(Preop)® and eliminate any excess intervention which leads to hypoglycemia intra-operatively. If blood sugars are checked prior to the two hour mark, excess insulin may be prescribed which leads to hypoglycemia intra-operatively. CF Nutrition provides a questionnaire to help create a standardization of care for checking blood glucose before, during and after surgery. 

What research studies support preoperative carb loading in patients with diabetes?

Administering a carbohydrate drink prior to surgery leaves some surgeons skeptical on the effects it may have on blood glucose levels. Unfortunately, several studies exclude diabetic patients. However, there are some studies that have been done to evaluate the safety of administering dextrose to diabetic patients undergoing surgery. Gustafsson et al conducted a study to evaluate the safety of preoperative carbohydrate loading on patients with diabetes. Twenty-five patients were included with type 2 diabetes (mean HbAlc 6.2± 0.2%) and 10 healthy control subjects. A carbohydrate drink (400mL, 12.5%) was given with the determination of gastric emptying. 

As expected, peak glucose was significantly higher in the diabetic patients compared to the control (p<0.01) and occurred later after intake of the carbohydrate drink (p<0.01). Glucose returned to baseline in 180 minutes in diabetic patients and 120 minutes in the control group (p<0.01). In terms of gastric emptying, at 120 minutes, 10.9 ± 0.7% and 13.3 ± 1.2% of paracetamol remained in the stomach in diabetic and healthy subjects respectively. Gastric half-emptying time occurred at 49.8 ± 2.2 minutes in diabetics and 58.6± 3.7 minute in healthy subjects (p<0.05). These results illustrate that there are no signs of delayed gastric emptying. Therefore, a carbohydrate drink can safely be administered 180 minutes before anesthesia without risk of hyperglycemia or aspiration risk preoperatively according to the results from this study.

​Furthermore, Li Na Ge et al conducted a systematic review to examine the effectiveness and safety of oral carbohydrates in those with diabetes. The review included 5 randomized control trials. Because there are no widely accepted indicators of the effects of preoperative carbohydrate in surgical patients with diabetes, this systematic review intended to offer a basis for the progress of ERAS® pathways for diabetic patients. This systematic review concludes that preoperative oral carbohydrate is effective, safe, and feasible for patients with diabetes. When a diabetic patient is fasted, the lack of glycogen reserve can lead to an insufficient energy supply, strong fluctuation of blood glucose, increased risk of hypoglycemia, nerve and kidney damage, and injury of tissues and organs. Additionally, prolonged fasting increases stress. This increased stress joint with surgical trauma can lead to increased glucocorticoids and glucagon, reduced insulin sensitivity, and reduced utilization of glucose in peripheral tissues. As a result, patients are at risk for postoperative hyperglycemia and increased insulin resistance. Postoperative insulin resistance can increase risk for developing infection and increasing length of stay. By consuming an oral carbohydrate 2-3 hours before surgery, the energy supply is enhanced consequently reducing perioperative hypoglycemia and insulin resistance. 

Providing a carbohydrate drink prior to surgery may help to reduce the stress response of surgery and put the body into a FED state entering surgery. Putting the body into a more normal physiological state entering surgery may be advantageous in overall recovery. 

What are CF Nutrition’s recommendations for CF(Preop)® and patients with diabetes?

With all this being said, here are important things to consider when providing CF(Preop)® to a diabetic patient:

1. Do they have a known risk for delayed gastric emptying? If so, consider adjusting the window for consuming CF(Preop)® per MD recommendations

2. A pt’s blood glucose will spike after the consumption CF(Preop)® however, it should return to baseline

3. Blood glucose should be checked regularly 

CF Nutrition  Recommendations:

Type 1 Diabetic 

With appropriate insulin administration, yields euglycemia. 

• 1st Bottle: Drink the night before surgery once in the fasting window 

• 2nd Bottle: Complete 2 hours before surgery Patients simply “match their short-acting insulin injections” to their blood glucose level and to the carb load that is listed on the drink label.

Type 2 Diabetic 

With preservation of their oral antihyperglycemic agent schedule at bedtime. 

• 1st Bottle: Drink the night before surgery once in the fasting window

• 2nd Bottle: Complete 2 hours before surgery Morning dose of oral agent may be held based on the actual surgical time, e.g., as when surgery is scheduled as one of the first cases of the morning.

Now that you know CF(Preop)® may be used in patients with diabetes, visit our website to purchase today!

Categories
For Med Pros Nutrition Preparing for Surgery

Prepare Your Patient for Surgery With CF Nutrition

At CF Nutrition, our goal is to help prepare your patient for surgery with premium nutrition beverages. Our mission is to use clean ingredients you can feel good about giving to your patients and we do not use any artificial ingredients or dyes. We know that surgery can be a stressful time so our products are designed to help reduce the surgical response of surgery and improve surgical outcomes. We have a full product suite that provides support to your patient before, during, and after their procedure.

Provide CF(Protein)® in the weeks leading up to surgery:

CF(Protein)® is a plant-based protein drink that provides a concentrated dose of natural electrolytes, antioxidants, and essential fats. CF(Protein)® is a great choice for anyone who is preparing for, or recovering from an operation. Plant protein is the modern way to give your body the best nutrients with the lowest impact on your digestive system.

Each CF(Protein)® has 13g of protein per bottle. So, depending on what else your patient is eating or drinking, and their specific protein needs, consuming 1 to 2 CF(Protein)® drinks per day can help ensure your patient is optimizing their nutrition prior to surgery. Prior to surgery, drinking 1-2 bottles per day (in addition to a well-balanced diet) for at least 2 weeks prior to surgery, will help your patient feel strong and well-nourished for their operation. 

Some benefits of drinking CF(Protein)® are:

·      Promote muscle maintenance, repair, and recovery

·      Strengthen the immune system

·      Reduce risk of malnourishment

·      Antioxidants & anti-inflammatory ingredients

·      Concentrated nutrition on-the-go

·      Healthy omega-3 and omega-6 fats

·      Naturally derived vitamins & minerals

·      Essential amino acids

·      Natural fiber sources

·      No artificial colors or flavors

·      Shelf-stable

·      Gluten-Free, Kosher, Vegan, Dairy-Free

·      Convenient on-the-go protein source

Recommend CF(Preop)® the night before and morning of surgery:

CF(Preop)® is a clear, colorless drink specifically formulated by an anesthesiologist for safe consumption in the hours before surgery. Each of its premium ingredients has been intentionally chosen to promote the highest level of presurgery safety, comfort, and nourishment.

It takes approximately 90 minutes for the oral carbohydrate solution to pass the stomach. Solid foods can be ingested up to 6 hours prior to surgery. The amount of carbohydrate to induce an effect must be enough to shift the body from a fasted to a fed state (50g carbohydrates 2 hours prior to surgery). There is no protein or fat in CF(Preop)® in order for it to safely empty your patient’s stomach before surgery. If your patient has delayed gastric emptying due to an underlying condition, CF(Preop)®  should be consumed 3-4 hours before the procedure. 

Provide CF(Rehydrate)®  or CF(Rehydrate)® Immunity+ after surgery:

After surgery, patients are oftentimes very dehydrated and can only have clear liquids. The intentional formulation behind both CF(Rehydrate)® and CF(Rehydrate)® Immunity+ replenishes lost fluids and essential electrolytes. CF(Rehydrate)® and CF(Rehydrate)® Immunity+ also has an ideal combination of carbohydrates and sodium to help you recover quicker. Recommending either post surgery can help promote recovery and hydration. 

Now that you know CF Nutrition offers a wide variety of products to help improve surgical outcomes, head to our website to purchase or receive samples!

Categories
Medical Professionals Preparing for Surgery

How is L-Citrulline better than L-Arginine?

CF(Preop)® contains L-citrulline to help improve blood flow by increasing nitric oxide levels. Other pre-surgery carbohydrate drinks contain L-arginine. Today, we break down why L-citrulline is more effective than L-arginine further illustrating that CF(Preop)® is the superior carbohydrate drink before surgery.

What is L-citrulline?

L-citrulline is a non-essential amino acid and we can make it in our bodies. L-citrulline is a key component of the urea cycle. 

What role does L-citrulline play in CF(Preop)®?

  CF(Preop)® contains L-citrulline. L-citrulline improves circulation by increasing nitric oxide levels, boosts the immune system by nourishing bowel electrolytes, and is efficiently converted to L-arginine. CF(Preop)®’s competitors do not contain L-citrulline.

Why is L-citrulline better than L-arginine?

When L-arginine is consumed orally, it undergoes significant breakdown by the enzyme arginase in our gastrointestinal pathway. Arginase hydrolyses arginine into ornithine and urea. When this happens, the result is low plasma L-arginine levels and lower bioavailability of L-arginine for nitric oxide synthesis. 

Furthermore, L-citrulline supplements are shown to increase arginine levels more than arginine supplements themselves. Arginine is subject to a number of pre-systematic and systematic elimination processes. Arginine is rapidly metabolized by liver and small intestine but catabolism of L-citrulline in the intestine is limited. L-citrulline is not metabolized by arginases and bacteria. L-citrulline is not extracted from the systemic circulation for clearance by the liver.

What are the benefits of supplementing L-citrulline?

Supplementation of L-citrulline:

  • May help with muscle recovery and blood flow
  • May reduce blood lactate levels
    •  L Citrulline can decrease lactate production and therefore increase time to exhaustion, in turn increasing physical performance 
  • Increases the circulation and tissue Arginine than an equivalent dose of Arginine 
  • May reduce blood pressure
  • Can increase nitric oxide synthesis activation
Categories
For Med Pros Preparing for Surgery

    CF Nutrition Products During Cancer Treatment

CF Nutrition products help nourish, hydrate, and better prepare your patients for surgery. Our products may be beneficial to your patients diagnosed with cancer to help them recover faster after surgery and to stay hydrated during treatments. 

 CF(Preop)® Before a Cancer Procedure

   If your patient is undergoing surgery related to their cancer treatment, CF(Preop)® can help them enhance their recovery after surgery. We recommend advising your patients to consume one CF(Preop)® at 8:00 PM the night before their surgery and one CF(Preop)® on the morning of their surgery (up to two hours before surgery/procedure).

           ERAS® protocols, specifically preoperative carbohydrate loading before surgery, have shown positive results in recent studies on cancer patients. Often, surgical resection is the only cure for certain types of cancer. During surgery, the body’s stress response increases, inhibiting immune function and increasing inflammatory markers (Wang et al.). In turn, recovery is delayed, and the risk for infection and postoperative complications increases. The goal of ERAS® protocols is to maintain organ function and decrease stress response following surgery. By reducing the stress response, the body will return to normal physiology sooner, which is crucial in cancer patients. Therefore, consuming CF(Preop)® before surgery will allow them to recover from their surgery sooner and decrease the risk for postoperative complications. 

CF Nutrition Products During Chemotherapy 

 If your patient is undergoing chemotherapy, consuming CF(Rehydrate)® throughout their chemotherapy duration can help them replenish their body with medical-grade nutrition and hydration needed to prevent dehydration. 

 If they are receiving chemotherapy, replenishing their body afterward is crucial. Dehydration is a common side effect of cancer treatments. Additionally, vomiting and diarrhea are also common side effects of chemotherapy which again lead to dehydration. We recommend advising patients to consume CF(Rehydrate)® or  CF(Rehydrate)® IMMUNITY+ after their session, along with the days following. In doing so, they will replenish their body with the vitamins, minerals, electrolytes, and fluid they need to feel better as soon as possible. Consuming CF(Rehydrate)® or  CF(Rehydrate)® IMMUNITY+ throughout their chemotherapy duration can help your patient to combat chemotherapy’s adverse side effects and prevent dehydration.  

         Unfortunately, if your patient is receiving chemotherapy, CF(Protein)® may not be recommended. It is important to note CF(Protein)® contains turmeric. Turmeric has blood-thinning properties and may interact with certain chemotherapy medications. When it comes to turmeric, the dosage does make a difference. There is 0.3g of turmeric in one bottle of CF(Protein)®.  Curcumin may act as an estrogen hormone. So, it may make hormone-sensitive conditions worse. Although this is not proven, if your patient has any hormone-sensitive need, avoid turmeric or use it with caution and only with MD approval. Hormone-sensitive conditions include breast cancer, uterine cancer, ovarian cancer, endometriosis, or uterine fibroids.

Now that you know what CF Nutrition products may be right for your patient undergoing a procedure or cancer treatment, head to our website to learn more and receive samples for your patients to try. 

Categories
Featured Posts For Med Pros Preparing for Surgery Presurgery Nutrition

What is ERAS®?

     ERAS® stands for Enhanced Recovery After Surgery. In the 1990s, Professor Henrik Kehlet founded Enhanced Recovery After Surgery (ERAS®), specifically in colorectal surgeries. There is now available research on ERAS in colorectal, vascular, thoracic, urosurgery, spine, neurosurgery, orthopedic, liver, pancreatic, and cardiac surgery. In the early 2000’s an ERAS society was formed that dedicated time to research preoperative care to improve recovery after surgery. The ERAS® society discovered that some traditional practices were no longer the best practice through evidence-based research. Since then, ERAS has gained much more consideration because of its overall advantageous effect on recovery after surgery, increased patient comfort, psychological well-being, decreased complications post-surgery, and reduced length of stay (LOS). 

What are the main pillars of ERAS®?

      The main ERAS® principles include protocols for preoperative, intraoperative, and postoperative care. All ERAS® protocols aim to lessen the body’s response to surgical trauma and maintain normal physiological function during surgery. 

ERAS® preoperative principles include:

  • pre admission counseling
  • fluid and carbohydrate loading
  • removing prolonged fasting
  • no/selective bowel preparation
  • antibiotic prophylaxis
  • thromboprophylaxis
  • no premedication

ERAS® intraoperative protocols include:

  • short-acting anesthetic agents
  • no drains
  • mid-thoracic epidural anesthesia
  • avoidance of salt and water overload
  • maintenance of normothermia

ERAS® postoperative protocols include:

  •  mid-thoracic epidural anesthesia
  • no nasogastric tubes
  • prevention of nausea and vomiting
  • avoidance of salt and water overload
  • early removal of the catheter
  • early oral nutrition
  • non-opioid oral analgesia NSAID
  • early mobilization
  • stimulation of gut motility
  • an audit of compliance and outcomes

What is the goal of ERAS® protocols? 

       As mentioned before, the goal of ERAS® protocols is to reduce the stress response of surgery. When the body undergoes surgical trauma, it can result in a metabolic state of stress. When the body is in this catabolic state, recovery will be slower, and complications are more likely to occur. Some complications associated with this exaggerated stress response are pain, paralytic ileus, increased cardiac demand, respiratory difficulties, increased insulin resistance, and increased infections. These complications lead to delayed recovery post-surgery. By lessening the body’s response to stress, ERAS® protocols help achieve early recovery and decrease LOS. Increased LOS and increased complications post-surgery is a significant issue for many medical professionals. ERAS® is beneficial to both the hospitals due to decreased LOS and costs and the patient as it increases patients comfort, reduces anxiety, and leads to faster recovery. 

Nutrition’s Role in ERAS®

    Nutritional status is critical before surgery. Ideally, a nutritional assessment is done before any surgery to reduce the risk of postoperative complications, increased length of stay, and infection risk. A patient can be diagnosed with mild or severe malnutrition by the MD. A Registered Dietitian assesses the patient for mild to severe malnutrition. The following criteria from Academy Adult Malnutrition Criteria (ASPEN) help to identify moderate malnutrition. A patient must have at least two of following to be diagnosed with moderate malnutrition: weight loss >2% in 1 week, >5% in one month, or >7.5% in 3 months; Energy intake less than or equal to 50% compared to estimated needs for greater than or equal to 5 days; Moderate body fat depletion; Moderate muscle mass depletion; Moderate to Severe Fluid Accumulation; and reduced grip strength. Furthermore, a patient must have at least two of the following to be diagnosed with severe malnutrition: Weight loss 1-2% in 1 week, 5% in one most, 7.5% in 3 months; Energy intake <75% compared to estimated needs in 7 days; mild body fat depletion; mild muscle mass depletion; Mild fluid accumulation; and Reduced grip strength. 

How to correct malnutrition before surgery?

If you need to correct malnutrition before surgery, using CF(Protein)® is a great way to build muscle and strength for a speedy recovery. Other ways to improve nutritional status can include enteral or parenteral nutrition. Obese patients may need to lose excess weight before surgery.

Why should you use CF(Preop)® over the NPO approach?

     Before ERAS® protocols, the traditional approach to surgery was to fast after midnight before surgery to decrease aspiration risk. In the 1990s, evidence-based research suggested that this was not necessary. Furthermore, there are detrimental effects caused by this period of prolonged fasting. Prolonged fasting worsens the catabolic state, increases metabolic stress, hyperglycemia, and insulin resistance. Furthermore, when the body fasts for a lengthy time, glycogen stores are depleted, leading to protein and muscle breakdown. Postoperative insulin resistance (PIR), a result of the stress response from surgery and further exaggerated with prolonged fasting, is directly related to delayed wound healing, increased morbidity/mortality, and LOS. PIR must decrease to enhance recovery after surgery.

Preoperative carbohydrate loading maximizes glycogen stores in the body as an energy source to minimize body tissues’ degeneration and reduce insulin resistance. By changing the metabolic state by shortening preoperative fasting (aka providing a complex carbohydrate 2-3 hours before surgery), PIR will decrease, protein loss reduces, and muscle function will improve. Additionally, preoperative carbohydrate loading increases patients’ comfort and reduces hunger, thirst, and anxiety, leading to surgery, all decreasing stress entering surgery. 

Specific Amounts of Nutrients Needed to Support Enhanced Recovery

CF(Preop)®  is a clear, colorless drink specifically formulated by an anesthesiologist for safe consumption hours before surgery. Each of its premium ingredients promote the highest level of pre surgery safety, comfort, and nourishment. It is designed to lower the risk of surgical site infections, reduce post-op recovery time, minimize post-op complication risk, and promote comfort and minimize stress. 

CF(Preop)®  is formulated for surgery and has all the ASA requirements to make it safe for consumption before your surgery. These requirements include a low osmolarity of 270mOsm to promote gastric emptying. It is clear and colorless and has no fat or protein and contains 50g CHO to shift the body from a fasted to fed state and promote enhanced recovery. It contains maltodextrin to help replenish glycogen depletion by catabolism related to fasting and surgery. Choosing to drink CF(Preop)® before your surgery helps you feel back to normal as soon as possible. 

Now that you know everything about ERAS® and how to prepare for surgery, visit our website to learn more. 

Categories
Featured Posts For Med Pros Preparing for Surgery

CF(Preop)® Before Surgery

Is CF(Preop)® safe before surgery?

Yes, CF(Preop)® is safe before surgery. CF(Preop)® was designed to be a pre-surgical drink. When you order CF(Preop)® you will be sent two bottles. One to be taken the night before your procedure, and one to be taken up to two hours prior to your surgery.

Since 1999 (and republished in 2011 & 2017) the American Society of Anesthesiologists guidelines on preoperative fasting have dictated that it is safe for healthy patients to have clear liquids up to 2 hours before surgery.

Click here to see the latest guidelines from the American Society for Anesthesiologists. 

Why was NPO even started?

Before Enhanced Recovery After Surgery (ERAS®) protocols were discovered, the traditional approach was to fast after midnight prior to surgery to decrease the risk for aspiration. In the 1990’s, evidence-based research suggested that this was not necessary. Furthermore, there are detrimental effects caused by this period of prolonged fasting. Prolonged fasting worsens the catabolic state, increases metabolic stress, hyperglycemia and insulin resistance. Furthermore, when the body is fasted for a prolonged time, glycogen stores are depleted which can lead to protein and muscle breakdown. Postoperative insulin resistance (PIR), a result of the stress response from surgery and further exaggerated with prolonged fasting, is directly related to delayed wound healing, increased morbidity/mortality and length of stay. 

Why is CF(Preop)® consumed up to 2 hours before surgery?

It takes approximately 90 minutes for the oral carbohydrate solution to pass the stomach. Solid foods can be ingested up to 6 hours prior to surgery. The amount of carbohydrate to induce an effect must be enough to shift the body from a fasted to a fed state (50g carbohydrate 2 hours prior to surgery). There is no protein or fat in CF(Preop)® in order for it to safely empty your stomach before surgery. 

If you or your patient have delayed gastric emptying due to an underlying condition,  CF(Preop)®  should be consumed 3-4 hours before the procedure. 

How can I be sure that CF(Preop)® is out of my system in time?

Low osmolarity 240mosmol/l solution is also recommended to promote effective gastric emptying and dispel concerns for gastric emptying. CF(Preop)® meets this requirement. The recommended approach is to provide a carbohydrate drink with complex carbohydrates 800mL at bedtime and 400mL 2 hours prior to any procedure. The drink should contain 12.5% maltodextrin to allow for complete gastric emptying prior to surgery. CF(Preop)® meets this requirement as well so there is no concern for delayed gastric emptying.

What are the benefits of CF(Preop)®?

To enhance recovery after surgery, it is important to decrease PIR. Preoperative carbohydrate loading maximizes glycogen stores in the body as an energy source in order to minimize degeneration of body tissues and reduce insulin resistance. By changing the metabolic state, by shortening preoperative fasting (aka providing a complex carbohydrate 2-3 hours prior to surgery like CF(Preop)®, PIR will be decreased, protein loss will be reduced, and muscle function will improve. Additionally, preoperative carbohydrate loading increases patients comfort and reduces hunger, thirst, and anxiety, all decreasing stress entering surgery. In conclusion, consuming CF(Preop)®before your procedure is not only safe but also beneficial in your recovery outcomes.

Now you know everything you need to know about CF(Preop)® and why it is so important to consume before surgery.

Categories
Featured Posts For Med Pros Preparing for Surgery Presurgery Nutrition

How do I use CF(Protein)® to Prepare for Surgery?

Whether you’re trying to preserve muscle mass following a procedure or replenish your body with nutrients after an athletic event, adding protein to your diet is a great way to give your body what it needs to be its best. CF(Protein)® was created for both ease and enjoyment. Thirteen grams of delicious, clean plant protein is packed into an 8-oz bottle that can be enjoyed on-the-go!

What are the benefits of CF(Protein)®?

CF(Protein)® is a plant-based protein drink that provides a concentrated dose of natural electrolytes, antioxidants, and essential fats. CF(Protein)® is a great choice for anyone who is preparing for, or recovering from surgery. Plant protein is the modern way to give your body the best nutrients with the lowest impact on your digestive system.

Some benefits of drinking CF(Protein)® are:

·      Promote muscle maintenance, repair, and recovery

·      Strengthen the immune system

·      Reduce risk of malnourishment

·      Antioxidants & anti-inflammatory ingredients

·      Concentrated nutrition on-the-go

·      Healthy omega-3 and omega-6 fats

·      Naturally derived vitamins & minerals

·      Essential amino acids

·      Natural fiber sources

·      No artificial colors or flavors

·      Shelf-stable

·      Gluten-Free, Kosher, Vegan, Dairy-Free

·      Convenient on-the-go protein source

How much CF(Protein)® should I drink leading up to surgery?

Each CF(Protein)® has 13 g of protein per bottle. So, depending on what else you are eating and drinking, and your specific protein needs, consuming 1 to 2 CF(Protein)® drinks per day can help ensure you are optimizing your nutrition prior to surgery. Prior to surgery, drinking 1-2 bottles per day (in addition to a well-balanced diet) for at least 2 weeks prior to surgery, will help you to feel strong and well-nourished for your operation. CF(Protein)® is not designed to be a sole source of nutrition. Therefore, consuming whole foods high in protein, is recommended before and after surgery in order to meet your protein and calorie needs.

What else is in CF(Protein)® other than protein?  

In addition to the protein content in CF(Protein)®, it also contains chia seed oil and turmeric which are anti-inflammatory. These will also help to ensure you are at optimal nutrition status for your surgery as well as strengthen your immune system. The antioxidants in CF(Protein)® will help you to fight off diseases and strengthen your immunity.

How do I determine my protein needs before surgery?  

There are a variety of factors that determine your specific protein needs. These include your age, activity level, chronic diseases, weight, and fitness goals. Typically, someone who is preparing for, or recovering from surgery has increased protein needs. This is to help the body ensure a speedy recovery.

To determine how much protein you need before or after surgery, take your body weight in kilograms and times it by 1.5 to 2.0. 

So, if you weigh 150LB:

·      Divide your weight in LB by 2.2 to get your weight in kg

o  150/2.2 = 68.2 kg

·      Next, multiply your body weight by 1.5 to 2.0

o  68 times 1.5=102; 68 times 2.0=136 g

·      You should consume 102-136 g per day of protein

If you have any chronic disease like COPD, Chronic Kidney disease, End Stage Renal Disease, HIV, or Cancer, please consult with your doctor or dietitian to determine your protein needs as they may be lower or higher based on your specific condition.

What if I am underweight?

If you are malnourished, it is important that you ensure adequate calories and protein leading up to your surgery. Nutritional status is crucial prior to surgery. A nutritional assessment should be completed prior to any surgery to reduce the risk for postoperative complications, increased length of stay, and risk for infection. A patient can be diagnosed with mild or severe malnutrition by the MD. A Registered Dietitian can also assess the patient for mild to severe malnutrition. 

Why is it important to correct malnutrition before surgery?

It is imperative to correct malnutrition in a patient prior to their surgery. Research proves that malnutrition is a leading reason for poor outcomes postoperative. Studies show that preoperative nutritional deficiency is a strong predictor of 90 days mortality and poor overall survival. Nutrition status can be improved with recommendations from a Registered Dietitian. Common recommendations include high protein supplements such as CF(Protein)®. CF(Protein)® is a plant-based protein product with complete nutrition to help build muscle and strength for a speedy recovery. Other ways to improve nutritional status can include enteral or parenteral nutrition. For obese patients, it is often required to lose excess weight prior to surgery.

If you are preparing for an upcoming surgery, CF(Protein)® can help you meet your increased protein needs and get your body ready for surgery. Visit our website https://drinkclearfast.com/ to learn more.

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Featured Posts For Med Pros Preparing for Surgery Presurgery Nutrition

Importance of Preoperative Nutrition Before Surgery

Nutrition plays a crucial role in surgical outcomes. Implementing nutrition screening and correcting malnutrition before surgery can help reduce readmission rates, postoperative infections, and length of stay. By understanding the components of preoperative nutrition medical professionals can help ensure patients receive the best standard of care.

What is preoperative nutrition?

Preoperative nutrition covers a wide variety of interventions—including nutrition screens, correcting nutrition status before surgery, patient education, and carbohydrate loading up to two hours before surgery. There is a lot involved in preoperative nutrition, and understanding each component can significantly enhance recovery, which is why it is a major component of ERAS®. 

Why does preoperative nutrition matter?

There is a strong association between poor nutrition status and surgical outcomes. Several studies report that preoperative nutrition to correct poor nutrition status improves outcomes postoperatively. To understand the importance of preoperative nutrition and correcting nutrition status before surgery, consider surgery analogous to a marathon. Before a marathon, you train for an extended period to ensure you will finish the race with the fastest time possible. If you have any injuries or illness, you would likely postpone running the marathon until you were healthy because, if not, you will not run as fast and perhaps wouldn’t even be able to finish the race. In the grand scheme of things, surgery is far more critical than running a marathon, so ensuring patients put in the same “training” to enter surgery at their strongest leads to smoother, faster recoveries.

What is the risk of preoperative malnutrition?

Preoperative malnutrition increases the risk for mortality and morbidity, and also increases costs. Malnutrition and cachexia are caused by proinflammatory cytokine response, inadequate dietary intake, and catabolic effects (Ward et al.). Preoperative malnutrition leads to increased susceptibility to infection, impaired wound healing, pressure ulcers, and increased length of stay (Abdelhamid et al.). Therefore, patients who are severely malnourished should correct malnutrition before surgery. In some cases, surgery is postponed until malnutrition is resolved.

Malnutrition and Surgery

Ideally, a nutrition assessment before any surgery can diagnose malnutrition. A Doctor or Registered Dietitian can evaluate the patient for mild to severe malnutrition. The Academy Adult Malnutrition Criteria (ASPEN) has specific criteria to identify malnutrition.

       Research proves that malnutrition is a leading cause of poor postoperative outcomes and it is a strong predictor of 90 days mortality and poor overall survival. Ward et al. suggest that preoperative anorexia and malnutrition increase postoperative complications in Whipple procedures. Furthermore, malnutrition in patients with pancreatic cancer can lead to cancer-related cachexia, defined as greater than 10% weight loss over six months.

CF Nutrition’s Role in helping prevent malnutrition

Nutrition status can improve with recommendations from a Registered Dietitian. Typical recommendations include high-protein supplements in the weeks leading up to surgery, such as CF(Protein)®.  CF(Protein)® is a plant-based protein drink patients can consume in the days and weeks leading up to surgery to optimize nutrition. It contains high-quality protein, omega-3 fatty acids, and anti-inflammatory ingredients that will enhance the immune system and optimize overall health. It is a complete nutrition product to help build muscle and strength for a speedy recovery.

Other ways to improve nutritional status can include enteral or parenteral nutrition if protein beverages are not enough to restore nutrition status. For obese patients, it is often required to lose excess weight before surgery. The macronutrient excess in those with obesity can be associated with chronic inflammation, sarcopenia, and micronutrient deficiency.

What about preoperative carb-loading?

Surgery induces a catabolic effect on the body. Reducing the fasting period can help reduce this catabolic effect and enhance recovery. Preoperative carbohydrate loading is also an essential component of preoperative nutrition. Prolonged fasting before surgery may cause detrimental effects. Prolonged fasting worsens the catabolic state, and increases metabolic stress, hyperglycemia, and insulin resistance. Furthermore, when the body fasts for a prolonged time, glycogen stores are depleted, leading to protein and muscle breakdown. Postoperative insulin resistance (PIR), a result of the stress response from surgery and further exaggerated with prolonged fasting, is related to delayed wound healing, increased morbidity/mortality, and LOS. Decreased PIR sets patients up for a smoother recovery.

Preoperative carbohydrate loading maximizes glycogen stores in the body as an energy source to minimize body tissue degeneration and reduce PIR. When you change the metabolic state by shortening preoperative fasting, PIR decreases, protein loss drops, and muscle function will improve. Additionally, preoperative carbohydrate loading increases patients’ comfort and reduces hunger, thirst, and anxiety leading up to surgery. Ultimately decreasing stress entering surgery. Our anesthesiologist-developed product, CF(Preop)®, may be consumed before surgery to enhance recovery and shift the body from a fasting to a fed state.

How does preoperative nutrition benefit the medical professional?

Screening patients’ nutritional status, correcting malnutrition and providing preoperative nutrition benefits patients and medical professionals alike. The patient will benefit from a smoother recovery—while the medical professional will benefit from cost savings, reduced length of stay and postoperative complications, increased patient satisfaction, and lower readmission rates.

  In summary, preoperative nutrition is a critical component of surgery. Nutrition screenings, correcting malnutrition, and preoperative carbohydrate loading are necessary interventions before performing surgery. CF Nutrition is here to help you better understand preoperative nutrition and how to incorporate it into your practice. Our products promote a smooth recovery and improved surgical outcomes. 

Categories
Preparing for Surgery Presurgery Nutrition

Improved Recovery From Surgery with CF(Preop)®

Recovery from surgery with CF(Preop)

Our team of nutritionists get asked one question pretty darn frequently: “What’s the magical ingredient in ClearFast that helps you recover from surgery?” Patients and clinicians so often want to know what the one secret ingredient is in our formulation that makes for reduced length of hospital stay, decreased risk of infection, decreased risk of post-op nausea, and a stronger, smoother surgery recovery. Today, then, we thought we’d dive into this frequently asked question to serve up some clarity. Read on for the answer!

What’s the secret ingredient in CF(Preop) that helps you recover from surgery?
Ah, we wish it was that simple, but—spoiler alert—there’s actually no magical ingredient that does the job on its own. Instead, every single ingredient in our anesthesiologist-developed formula works together to create a smoother surgery and enhanced recovery. 

Why isn’t there one star ingredient in CF(Preop) that helps you recover from surgery?
When a board-certified anesthesiologist was working to develop ClearFast, she did so with one goal in mind: to empower patients to take control of their surgery experience. She saw so many patients coming in for surgery under- or mal-nourished (especially after following the old-school “nothing from midnight” fast)—which led to an array of complications like surgical infections and a slow, complicated recovery.

Both modern medical research pointed to the fact that going into surgery nourished—instead of starved and dehydrated—was the key for a smoother, faster surgery recovery. (The healthier and better nourished you are before surgery, the faster and stronger your recovery after surgery.) So, instead of focusing on finding one “magical” ingredient, she developed a formula that contains exactly what patients need—and in the precise quantities they need it—for powerful clinical nutrition and medical-grade hydration in one proven product.

What ingredients in CF(Preop) help you nourish before your procedure and recover from surgery?

We’re so glad you asked! Our formula leverages a handful of natural, science-backed ingredients proven to enhance your surgery recovery in one tasty presurgery drink. They include:

  • Zinc Sulfate: Supports the immune system to keep you strong and safe as you enter surgery
  • Vitamin A: Has powerful antioxidant properties
  • L-Citrulline: Promotes circulation and wound healing for a faster recovery
  • Filtered Water: Ensures you (and your veins) are hydrated for easier IV “sticks” 
  • Citric Acid: For kidney health and free radical neutralization
  • Maltodextrin: Complex carbs for medical-grade nourishment and reduced muscle-mass loss

Is there anything you leave out of CF(Preop)?

Every product we formulate here at ClearFast—from our presurgery drinks to our plant protein drinks—are designed to help you nourish naturally, so you’ll never find added sugars, artificial ingredients, or unnecessary fillers in anything we make. 

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Ready to start working doctor-trusted, patient-preferred premium clinical nutrition into your presurgery nutrition plan? You can order CF(PreOp)® here.  And, as always, don’t hesitate to reach out to the ClearFast team at support@drinkcf.com if you have any questions at all. We’re always here and happy to help!

Categories
Preparing for Surgery

Importance of ERAS® in a COVID-19 World

ERAS during COVID 19

As COVID-19 is now a part of our daily lives, it’s so important patients do everything they can to ensure their body is strong and healthy as they enter a hospital setting for surgery. Today, then, we’re diving deep into ERAS® (Enhanced Recovery After Surgery) and why it’s more important now than ever. Read on for everything you need to know about a safe surgery and strong recovery—even during the crazy times of Coronavirus!

What is ERAS?

We’re glad you asked! Enhanced Recovery After Surgery—known in the medical field as  ERAS—is a program all about facilitating a faster recovery by taking proactive steps before surgery to reduce the amount of stress the body undergoes during surgery. 

What is the ERAS program?

ERAS programs focus on implementing different practices to ensure recovering from your procedure is as safe, healthy, and seamless as it can be. These programs are comprised of 17 key elements for your doctors to follow—like pre-admission counseling for patients, the use of short-acting anaesthetic agents, and fluid-fasting with a presurgery drink in place of the traditional “no food or drink after midnight” fast. When you and your doctor follow the elements of an ERAS program, they work together to ensure better surgical outcomes and—just like its name says—an enhanced recovery after surgery.

Why does ERAS matter more now? 

There are a few reasons following ERAS is more important during COVID-19 than it’s ever before been (though we’d argue it’s always pretty darn important!).

  • The first is that surgery stresses and suppresses your immune system, which isn’t ideal as hospitals are battling COVID-19. If you have to be stuck in a hospital for surgery during a pandemic, you want to make sure your immune system is as strong as it can be to handle any unwelcome invaders that might come its way—and following an ERAS program is one of the most effective ways you can do this. (Psst..check out a few other ways you can give your immune system a boost before surgery).

  • The second is that getting out of a hospital fast is pivotal in the midst of a pandemic. Both for your safety (most importantly!) and to help keep resources available for COVID patients, you don’t want to spend any more time than is necessary in a hospital bed. The great news is that ERAS programs are proven to shorten hospital stays. In fact, according to a PubMed analysis of randomized trials, “Three of four included studies showed significantly shorter primary lengths of stay for patients enrolled in enhanced recovery programs.” So, following an ERAS program is a great way to get you out of those scratchy hospital sheets and back home safely, faster.

How can I implement ERAS protocols before my surgery? 

The act of undergoing anesthesia is super stressful on the human body. Because of this, the idea behind ERAS is to prepare our bodies for that stressful experience in a more purposeful way than we have in the past. There are a number of things you can do to implement an ERAS protocol before your surgery, including: 

  • Quit smoking and avoid alcohol
  • Exercise and lose weight if needed
  • Make healthy dietary choices and implement a presurgery nutrition plan before your procedure
  • Replace the “nothing from midnight” rule with a specific fluid fast with CF(PreOp)®

Psst…lingering on that last bullet-point and wondering why ERAS has you replace the nothing-from-midnight fast with a fluid fast using a clinical nutrition drink like CF(PreOp)®? Practices that have patients refrain from eating or drinking anything after midnight are outdated and can lead to post-op nausea and vomiting (PONV) amongst other issues. Instead, modern medical research points to the fact that replacing the old-school nothing-from-midnight fast with a clear, carbohydrate-rich beverage leads to a reduced risk of aspiration, a decreased chance of PONV, a faster recovery, and a shortened overall hospital stay. Sign us up!

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Ready to start working doctor-trusted, patient-preferred premium clinical nutrition into your everyday diet as you focus on following proven ERAS protocols for your upcoming procedure? You can order CF(PreOp)® here or CF(Protein)® here.  And, as always, don’t hesitate to reach out to the ClearFast team at support@drinkcf.com if you have any questions at all. We’re always here and happy to help!

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